AB0533 THE ASSESSMENT OF CLINICAL CHARACTERISTICS OF MALE SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS
Authors: M. Canbaş, S. Colak, E. Tekgoz, M. Çinar, S. Yilmaz
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic lupus erythematosus (SLE) is a multisystemic chronic autoimmune disease that is nine times more frequent among females. Due to a female dominancy, the data regarding male patients is limited. Objectives This study aimed to evaluate the clinical characteristics of male patients with SLE. Methods This retrospective study included male SLE patients who followed up in a tertiary rheumatology outpatient clinic between October 2016 and December 2021. Those who met the Systemic Lupus International Collaborating Clinics (SLICC) criteria were included. The data of the patients and SLE Disease Activity Index-2000 (SLEDAI-2K) values were obtained from files. Results There were 40 male SLE patients with a mean age of 42.7 ± 17.3 years. The median age of diagnosis was 30 years, and the median disease duration was 63.5 months (ranges between 5-444). The mean value of the SLICC score was 4.7 ± 0.8. The most frequent initial clinical manifestations were thrombocytopenia and photosensitivity, which were seen in 8 (9.6%) patients each (Table 1). Six (15%) patients had secondary antiphospholipid antibody syndrome. Thirty-five (87.5%) patients achieved remission, but 14 (35%) patients had at least one relapse in the follow-up period. The most frequent manifestation after relapse was nephritis in 9 (22.5%) patients that had no renal involvement at the time of diagnosis. The median SLEDAI score was 2 (ranges between 0-12). The most commonly preferred drug for the treatment was hydroxychloroquine and corticosteroids (92.5% for each). Nineteen (47.5%) patients received pulse steroids. Besides, the most frequently prescribed immunosuppressive drug was mycophenolate mofetil (37.5%). The rates of azathioprine, cyclophosphamide, methotrexate, cyclosporine A, rituximab, intravenous immunoglobulin, and leflunomide usage were 30%, 27.5%, 17.5%, 10%, 7.5%, 7.5%, 5%, respectively. Antinuclear antibody (ANA) was positive in 35 (87.5%) patients, and anti-dsDNA was positive in 9 (22.5%). The median level of anti-dsDNA titers was 40 IU/ml (ranges between 23-200). Other autoantibody positivity rates were; 12 (30%) for anti-Sm, 6 (15%) for anti-histon, 4 (10%) for anti-RNP and 4 (10%) for anti-nucleosome. Thirteen (32.5%) patients had low C3 levels, and 11 (27.5%) patients had low C4 levels. The hospitalisation rate was 55%, and no death was seen during follow-up. Table 1. Clinical characteristics of the patients (n=40) Characteristics Patients Clinical manifestations, n(%) Initial Relapse Thrombocytopenia 8 (20) None Photosensitivity 8 (20) None Anemia 7 (17.5) None Malar rash 6 (15) 2 (15) Nephritis 6 (15) 9 (22.5) Arthiritis/synovitis 5 (12.5) 6 (15) Subacute lesions 4 (10) 2 (5) Leukopenia/lymphopenia 4 (10) None Thrombosis 3 (7.5) 4 (10) Neurological involvement 3 (7.5) None Serositis 2 (5) 2 (5) Pulmonery involvement 2 (5) None Discoid lupus erythematosus 1 (2.5) 1 (2.5) Myositis 1 (2.5) None Conclusion Since SLE is more prevalent among females, it may occur in male patients with mild or life-threatening manifestations. In the current study, the seropositivity was less than in the literature, which may indicate male patients should be cautiously evaluated. Although renal involvement is not an initial manifestation, it may develop during the follow-up. Disclosure of Interests None declared